Health insurance in the USA.
The US has no public plan you can simply join. Some visas set minimum cover. Others leave it to you. Here is what a J-1 needs, who can use the Marketplace, and what plans cost.
The rules
What USA asks of you.
Checked against official sources on 23 October 2026. Rules change, so the broker confirms them again before you apply.
- J-1 visa: set minimum cover
J-1 sponsors must make sure you have cover for sickness and accidents. The minimum is 100,000 dollars of medical benefits per accident or illness, 25,000 dollars for returning remains, 50,000 dollars for medical evacuation, and a deductible of no more than 500 dollars.
Source: law.cornell.edu - J-1: spouse and children too
Sponsors must require that an accompanying spouse and dependants also have insurance for sickness and accidents.
Source: law.cornell.edu - J-1: what the policy may include
The policy may make you pay up to 25% of covered costs. It may have a reasonable waiting period for conditions you already have. The insurer must meet a minimum rating, such as A.M. Best A- or above.
Source: law.cornell.edu - Marketplace: lawfully present people can enrol
People with lawful status can buy a plan on the ACA Marketplace if they are otherwise eligible. This includes people on nonimmigrant visas, such as work and student visas. People without lawful status cannot.
Source: healthcare.gov - Savings narrow on 1 January 2027
From 1 January 2027, only green card holders, Cuban or Haitian entrants and Compact of Free Association migrants can get Marketplace savings. Other lawfully present people can still buy a plan, but at full price.
Source: healthcare.gov - Medicaid: 5-year wait
Medicaid and CHIP are for people who meet state income rules and have an eligible status. You are generally eligible 5 years after you get qualified non-citizen status. Some states remove the wait for children and pregnant women.
Source: healthcare.gov
There is no national public plan for working age adults. Medicaid and CHIP are for low income people, and new arrivals generally wait 5 years. Most expats rely on a private plan, either through an employer, the Marketplace or an international insurer.
Source: healthcare.govLocal or international
We compare both. You keep the one that fits.
From 2027, most visa holders pay full price for a Marketplace plan, with no savings. That makes an international plan worth comparing, above all for J-1 holders who need evacuation and repatriation cover.
- Local plans
Plans sold in USA. Often cheaper, sometimes required for your visa. Filed by a broker licensed in USA.
- International plans
Plans that cover you in USA and beyond, and stay with you if you move again. Filed by our international broker partner.
What it costs
Published prices in USA.
List prices from insurers and official schemes. Your quote depends on your age, health and the cover you pick.
- Benchmark silver plan: 625 dollars a month
The 2026 national average for a 40-year-old, before any savings. The benchmark is the second-lowest silver plan in each county.
Source: kff.org - Cheapest bronze plan: 456 dollars a month
The average lowest-cost bronze premium for a 40-year-old across US counties in 2026.
Source: kff.org - Most you pay in a year: 10,600 dollars
The 2026 cap on in-network costs for 1 person on a Marketplace plan. For a family it is 21,200 dollars.
Source: healthcare.gov
What to look for
Choosing a plan in USA.
Ankyro checks each of these on every plan, so you don’t have to read the fine print.
- Where you can be treated
US plans use networks. Check that your doctors and hospitals are in network, and what happens if you go out of network.
- Deductible and out of pocket limit
Look at how much you pay before cover starts, and the most you can pay in a year. On a 2026 Marketplace plan, that yearly cap can reach 10,600 dollars for 1 person.
- Pre-existing conditions
J-1 policies may apply a waiting period to a known condition. Other plans have their own rules. Read the exclusions.
- Evacuation and repatriation
The J-1 rules ask for evacuation and return of remains. Many US plans do not include these, so check.
Step by step
Getting covered in USA.
- 01Check what your visa asks for. J-1 sponsors must make sure you meet set minimums, and so do a spouse and children with you. Many other visas leave the choice to you.
- 02Gather your immigration documents. The Marketplace asks for details from papers such as your I-94, I-20, DS-2019 or foreign passport. Which ones depends on your status.
- 03Apply after you move, with a special enrolment period. Moving to the US from abroad can open a special enrolment period. You then don’t have to wait for open enrolment, which runs 1 November to 15 January.
- 04Or enrol by 15 December for 1 January. In open enrolment, pick a plan and pay the first premium by 15 December, and cover starts on 1 January.
- 05Budget for full price from 2027. From 1 January 2027, savings go only to green card holders, Cuban or Haitian entrants and COFA migrants. On a work or student visa, plan for the full premium.
Common mistakes
3 we see all the time.
- 01Going without cover because your visa does not ask for it. There is no public plan to fall back on, and Medicaid generally means a 5-year wait.
- 02Buying a plan below the J-1 minimums. The sponsor can ask for more than you bought.
- 03Planning on Marketplace savings from 2027 on a work or student visa. They will not apply to most visa holders.
Real published prices, and the 6 things that move yours.
Just visiting?For a holiday or a short trip, travel insurance is enough. See what the USA asks of visitors, and what care costs.
Questions
People also ask.
Do I need health insurance for a J-1 visa?+
Yes. Sponsors must make sure you have cover with at least 100,000 dollars per accident or illness, 25,000 dollars for returning remains, 50,000 dollars for evacuation, and a deductible of no more than 500 dollars.
Can foreigners buy ACA Marketplace insurance?+
Yes, if they are lawfully present and otherwise eligible. This includes people on nonimmigrant visas such as work and student visas.
Can I get Marketplace savings as a visa holder?+
Not from 1 January 2027. Savings will be limited to green card holders, Cuban or Haitian entrants and Compact of Free Association migrants.
Can expats use Medicaid in the USA?+
Only with an eligible status and low income. You are generally eligible 5 years after getting qualified non-citizen status.
Other countries
Going somewhere else?
Most UK visas don’t ask for private insurance. You pay a yearly surcharge instead, and it opens the NHS. Here is what the surcharge buys, and what you still pay for.
02AustraliaMost visitors can’t use Medicare, and many visas carry condition 8501. Here is what each visa asks for, who gets Medicare, and what to check.
03Dubai and the UAEIn Dubai, no insurance means no visa. Your employer covers you, but not always your family. Here are the rules, and what the basic plan leaves out.
04PhilippinesThe retiree visa asks for a medical certificate, not a policy. The new nomad visa does ask for cover. Here is what each visa needs, and how PhilHealth works for foreigners.
05NetherlandsIf you live or work in the Netherlands, Dutch basic insurance is the law. A few people are exempt. Here is who must sign up, by when, and what it costs in 2026.
06CanadaEach province runs its own health plan, and some make you wait. The super visa has strict insurance rules. Here is how Ontario and BC differ, and what the super visa needs.
07Saudi ArabiaIn Saudi Arabia, no insurance means no iqama. Your employer pays for you and your family, and visitors need a policy too. Here is who pays, and what each policy covers.
08JapanIf you live in Japan, joining public insurance is the law. A private plan can only sit on top. Digital nomads are the exception.
09GermanyEveryone in Germany must be insured, and a residence permit needs cover equal to the public system. Here is how to choose, and what gets rejected.
10SingaporeThe national plan is for citizens and PRs. Hospital bills for foreigners are high, and families are often left out. Here is what to check.
11ThailandRetirement visas have hard minimums, the DTV has none, and public care is not free for foreigners. Here are the rules, and what to check.
12SpainSpain has the strictest visa insurance rules in Europe: a Spanish-authorised insurer, no co-pays, no waiting periods. Here is what passes.
13MalaysiaPublic hospitals charge foreigners full price, and work schemes only cover injuries at work. Here is what each pass asks for, and what to check.
14QatarMost visitors need a QAR 50 a month policy before Qatar issues a visa. The law covers expats too, but that part is still rolling out. Here are the rules.
15FranceThe public system is open to residents, but not on day 1 if you don’t work, and it only pays part of each bill. Here is how to cover the gaps.
16PortugalThe visa asks for travel medical cover. The public system opens once you are a resident. In between, and after, here is what to check.
17MexicoNo visa asks for it, so many expats skip it. Then a private hospital asks for payment first. Here is how cover really works in Mexico.
18ItalyWorkers join the public system for free. Retirees and nomads need private cover for the visa, then pay at least €2,000 a year to join. Here are the rules.
19South KoreaStay more than 6 months and you must join the national plan. Before that, and for your share of each bill, you need your own cover.
20VietnamOnly long local contracts come with public cover, and most expats use private hospitals anyway. Here is what the rules say, and what to check.
21Bali and IndonesiaMost Indonesian visas don’t ask for insurance. But hospitals ask for payment first, and serious cases fly to Singapore. Here is what to check.
22GreeceThe consulate takes travel cover for the visa. The residence permit then asks for full health cover. If you don’t work for a Greek employer, that means a private plan.
23ColombiaNomads and retirees need a private policy with exact wording. Residents who work must join the public EPS system. Here are the rules.
24Costa RicaResidents must pay into the Caja, whatever private plan they have. Nomads need their own cover for the visa. Here is how it fits together.
26SwitzerlandBasic health insurance is compulsory for everyone who lives in Switzerland. You have 3 months to sign up. Here is how it works, and what to check.
27IrelandNon-EEA students must hold private medical insurance. Everyone else gets public care once they count as living in Ireland for 1 year. Here is what to check.
28Dominican RepublicThe residence visas for retirees and rentistas ask for a medical certificate, not an insurance policy. Public care is limited. Private care is good but costly.
29New ZealandStudent visas require insurance. A work visa of 2 years or more may open public health care. ACC covers accident injuries. Here is what to check.
30IsraelIn Israel, the public system is for residents. If your life is centred there, you join a health fund (kupat holim). If not, you need private cover.
31Hong KongPublic hospitals in Hong Kong are cheap for eligible persons. Many foreigners are not on that list. Here is who is, what the rest pay, and what to check in a plan.
32ChinaIf you work in China on an employment permit, your employer must enrol you in social insurance. That includes basic medical cover. Here is how it works, and what to check on top.
33ArgentinaEmergency care is open to everyone. For other care at national hospitals, foreigners without permanent residence must show insurance or pay first. The rules are new, so check them.
34IndiaWe found no official rule that ties health insurance to an Indian work visa. We also could not confirm a public scheme for foreign residents. So the plan is yours to choose. Here is what to check.
35TurkeyA residence permit application needs valid health insurance for the whole permit. Most new expats buy a private policy. The public SGK system opens later, after 1 year of residence.
36BrazilThe digital nomad visa needs health insurance valid in Brazil. The public system is open to migrants by law. Many expats add a private plan for speed.
37PanamaThe Pensionado visa asks for a health certificate, not an insurance policy. The public system is tied to the Caja. Private care is the main option for most expats.
38South AfricaStudy and exchange visas ask for proof of cover from a registered medical scheme. Public clinics offer free primary care. Here is what to check.
39KenyaKenya’s public fund is run by the Social Health Authority (SHA). A foreigner who lives in Kenya for more than 12 months pays into it. Shorter stays need travel health insurance instead.
40TaiwanTaiwan has one national health insurance. Foreigners with a residence certificate can join. If you have a job, you join through your employer. If not, there is a wait.